[Metallic foreign bodies of brain ventricles]. / Metallicheskie inorodnye tela zheludochkov golovnogo mozga.

Head injuries are often associated with intracranial foreign bodies that require decision making on the need for certain surgical treatment. Intraventricular foreign bodies are rare, so the question of surgical tactics is still open. OBJECTIVE: To summarize the experience of treating the wounded with intraventricular foreign bodies. MATERIAL AND METHODS: Treatment outcomes in victims with foreign bodies in lateral ventricles are presented. Searching in the e-Library, PubMed, Google Scholar databases included the following keywords: «penetrating wounds¼, «foreign bodies¼, «cerebral ventricles¼, «gunshot injury¼, «ventricular foreign bodies¼. We analyzed data on the treatment of victims with intraventricular foreign bodies. RESULTS: Three victims underwent surgery, and foreign bodies were removed from the occipital horn of the lateral ventricle, third ventricle and temporal horn of the lateral ventricle. Conservative approach was preferred in 1 case. Follow-up ranged from 1 month to 7 years, GOS score - 3-4 points. Disability was due to severe injury and not associated with surgical treatment per se. We found 16 publications matching the searching criteria. Treatment methods varied from standard surgical approaches to stereotactic management. The indication for removal of foreign bodies was their migration through the ventricular system and occlusive hydrocephalus. None patient had neurological aggravation. CONCLUSION: Intraventricular foreign bodies are rare and present certain difficulties in choosing the method and timing of treatment. Indications for their removal are migration, occlusive hydrocephalus and infectious complications. The method of removal is determined depending on location, magnetic properties, nature of injury, surgical preferences and other factors.

[Stereotactic photodynamic therapy for recurrent glioblastoma. Case report and literature review]. / Stereotaksicheskaya fotodinamicheskaya terapiya v lechenii retsidiva glioblastomy. Sluchai iz praktiki i obzor literatury.

We report a patient with recurrent glioblastoma in eloquent brain area. Stereotactic fluorescence biospectroscopy and stereotactic photodynamic therapy of tumor in opercular area of the left frontal lobe under neurophysiological monitoring were carried out. Literature data on this issue were analyzed.

[Tomography findings in optic nerve head and retina in differential diagnosis between normal-tension glaucoma and ischemic optic neuropathies].

AIM: to determine tomography findings in optic nerve head (ONH) and retinal nerve fiber layer (RFNL) that may be valuable for differential diagnosis between normal-tension glaucoma (NTG) and ischemic optic neuropathy (ION) outcome. MATERIAL AND METHODS: Group 1 consisted of 17 patients (32 eyes) with NTG, group 2--17 patients (24 eyes) with ION outcome. The control group included 22 patients (22 eyes) with no sighs of optic neuropathy. Optic nerve head and retina assessment included scanning laser ophthalmoscopy (HRT 111) and optical coherence tomography (Stratus OCT 3000). Statistical analyses were performed using Statistica 10 software suite. RESULTS: Statistically significant changes in HRT parameters, namely, the mean RNFL thickness, retinal height variation along the contour line, and RB discriminant function, were observed in both study groups as compared to the controls. NTG patients also showed lower rim indices, larger cups, smaller values of the FSM discriminant function, and lower GPS (glaucoma probability score) than both ION patients and the controls. OCT findings included a statistically significant decrease in RNFL thickness in both study groups as compared to the controls. As for the difference between the groups, it was unreliable. Quadrant comparisons of RNFL thicknesses revealed that lower quadrant RNFL thinning was more significant in NTG patients, while temporal quadrant RNFL thinning--in ION patients. CONCLUSION: Both conditions are associated with a similar degree of RNFL thinning, as confirmed by OCT, however, HRT changes are much more pronounced in NTG than in ION patients.

[Effects of blood flow properties on ocular hemodynamics].

AIM: to study the effects of blood rheology on ocular blood flow (OBF) parameters and estimated individual normal range of intraocular pressure (IOP). MATERIAL AND METHODS: A total of 15 patients (15 eyes) taking warfarin were enrolled. Volumetric parameters and linear velocity of OBF under warfarin treatment and after its cessation were obtained by means of flowmetry (Paradigm's Blood Flow Analyzer) and color Doppler flow mapping (Voluson 730), respectively. On the basis of flowmetry results an individual normal range of IOP was calculated in all patients. RESULTS: Pulsatile OBF does not appear to correlate with warfarin-induced changes in blood rheology (p = 0.09), however, depends on IOP fluctuations (p = 0.02). Resistance index of retinal vessels is found to rise significantly with increasing blood viscosity (p < 0.05). CONCLUSION: The use of warfarin, an indirect thrombin inhibitor, has no effect on estimated individual normal range of IOP, which is crucial for glaucoma diagnosis and monitoring.

[Ocular blood flow and carotid artery malfunction].

AIM: to evaluate ocular hemodynamics and informativity of estimated individual normal range of intraocular pressure (IOP). MATERIALS AND METHODS: A total of 12 patients (22 eyes) with carotid artery malfunction were examined. Ocular blood flow (OBF) and IOP were measured with Ocular Blood Flow Analyzer. Actual OBF was then compared with what is considered normal for a given axial length (AL). Individual normal range of IOP was calculated according to an original formula (described in previous publications). Doppler imaging of ocular vessels enabled blood flow velocity measurement. Morphological parameters and functional status of the retina and optic nerve were judged on automated perimetry (Octopus 900) and optical coherence tomography (Cirrus HD-OCT) findings. Statistical analyses were performed using Statistica 10 software. RESULTS: Generally, OBF showed no correlation with the grade of carotid artery stenosis (p < 0.05), however, was significantly reduced as compared to its AL-dependent norm in patients with greater than 85% narrowing of the internal carotid artery, which can cause misestimating of their individual normal range of IOP. A negative relationship was established between the blood flow velocity in short posterior ciliary arteries and the grade of internal carotid artery stenosis (p < 0.005). Ocular blood flow deficit relative to the AL-dependent norm correlated with ophthalmic artery resistance index. CONCLUSION: OBF-based estimation of individual normal range of IOP is inexpedient in patients with greater than 80% carotid artery stenosis due to its possible influence on ocular hemodynamics. In most cases of less than 80% carotid artery stenosis OBF is adequate or slightly reduced as compared to its AL-dependent norm and thus, has no significant impact on estimated individual normal range of IOP.